A journey without maps-Understanding the costs of caring for dependent older people in Nigeria, China, Mexico and Peru.

Journal: PloS one

Volume: 12

Issue: 8

Year of Publication: 2017

Affiliated Institutions:  Health Service and Population Research Department, King's College London (Institute of Psychiatry, Psychology and Neuroscience), London, United Kingdom. School of International Development, University of East Anglia, Norwich, United Kingdom. Instituto de la Memoria y Desordenes Relacionados, La Molina, Lima, Peru. Peking University, Institute of Mental Health, Beijing, China. National Institute of Neurology and Neurosurgery of Mexico, Autonomous National University of Mexico, Delegacion Tlalpan, Mexico City, Mexico. Department of Sociology/Anthropology, Nnamdi Azikiwe University, Awka, Anambra State, Nigeria.

Abstract summary 

Populations in Latin America, Asia and sub-Saharan Africa are rapidly ageing. The extent to which traditional systems of family support and security can manage the care of increased numbers of older people with chronic health problems is unclear. Our aim was to explore the social and economic effects of caring for an older dependent person, including insight into pathways to economic vulnerability.We carried out a series of household case studies across urban and rural sites in Peru, Mexico, China and Nigeria (n = 24), as part of a cross-sectional study, nested within the 10/66 Dementia Research Group cohort. Case studies consisted of in-depth narrative style interviews (n = 60) with multiple family members, including the older dependent person.Governments were largely uninvolved in the care and support of older dependent people, leaving families to negotiate a 'journey without maps'. Women were de facto caregivers but the traditional role of female relative as caregiver was beginning to be contested. Household composition was flexible and responsive to changing needs of multiple generations but family finances were stretched.Governments are lagging behind sociodemographic and social change. There is an urgent need for policy frameworks to support and supplement inputs from families. These should include community-based and residential care services, disability benefits and carers allowances. Further enhancement of health insurance schemes and scale-up of social pensions are an important component of bolstering the security of dependent older people and supporting their continued social and economic participation.

Authors & Co-authors:  Mayston Rosie R Lloyd-Sherlock Peter P Gallardo Sara S Wang Hong H Huang Yueqin Y Montes de Oca Veronica V Ezeah Peter P Guerra Mariella M Sosa Ana Luisa AL Liu Zhaourui Z Uwakwe Richard R Guerchet Maëlenn M MM Prince Martin M

Study Outcome 

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Statistics
Citations :  Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. Lancet. 2007;370(9603):1929–38. doi: 10.1016/S0140-6736(07)61696-1 .
Authors :  13
Identifiers
Doi : e0182360
SSN : 1932-6203
Study Population
Women,Female
Mesh Terms
Aged
Other Terms
Study Design
Case Study,Narrative Study,Cross Sectional Study
Study Approach
Country of Study
Niger
Publication Country
United States